EP1267755B1 - Implant de corps vertebral de hauteur variable et kit d'instruments pour le manipuler - Google Patents
Implant de corps vertebral de hauteur variable et kit d'instruments pour le manipuler Download PDFInfo
- Publication number
- EP1267755B1 EP1267755B1 EP01919410A EP01919410A EP1267755B1 EP 1267755 B1 EP1267755 B1 EP 1267755B1 EP 01919410 A EP01919410 A EP 01919410A EP 01919410 A EP01919410 A EP 01919410A EP 1267755 B1 EP1267755 B1 EP 1267755B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- cage
- implant
- cages
- guide rod
- shaped
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30599—Special structural features of bone or joint prostheses not otherwise provided for stackable
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
- A61F2250/0063—Nested prosthetic parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
- A61F2250/0064—Sets comprising a plurality of prosthetic parts of different sizes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0085—Identification means; Administration of patients
- A61F2250/0087—Identification means; Administration of patients colour-coded
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
Definitions
- the invention relates to an implant device according to the preamble of patent claim 1.
- a support rod with laterally slidable implant bodies is known.
- the implant body In order to enable a sliding, the implant body have a lateral groove, wherein a corneanstrukt ist in the form of a toothing of the fixation of the surfaces of the implant body with each other and beyond the location preservation with respect to the or the vertebral body is used.
- a corneanstrukt ist in the form of a toothing of the fixation of the surfaces of the implant body with each other and beyond the location preservation with respect to the or the vertebral body is used.
- the fact that the implant body shown there are prefabricated at different heights and can be pushed onto the support rod, can be done in a certain way a height adjustment.
- the handling of the implant is extremely difficult under operational conditions and the production costs are high.
- an implant in U-shape wherein openings are provided there, which serve to receive bone cement.
- Other openings may be present as a receptacle for a screw to fix the implant directly in the vertebra.
- carbon fiber reinforced plastic for the implant shown.
- the implant spacer according to EP 0 268 115 A1 has a cylinder jacket element with a large number of grid-network-shaped recesses.
- a ring provided there at the upper and lower end of the cylinder jacket element prevents unwanted too deep penetration of the implant into the vertebra.
- the same purpose serves an additionally provided bottom plate.
- the cylinder jacket element is closed and in addition to the diamond openings has no further for introducing bone cement, so that there are difficulties in the operative handling with disadvantages in bone cement injection.
- the support device is made of titanium and is flat and elongated and widened in its central region. The edges have a sawtooth profile except for the center region.
- the shape of the presented support device is similar to that of an open ring, wherein the support device can be adapted to the diameter side different applications by the bending of the end portions.
- a height-variable vertebral body replacement with a sleeve and a first abutment body displaceable in the axial direction or a second abutment is known from DE 44 09 392 A1.
- a threaded device is provided to move the abutment body with each other.
- a similar principle is shown in DE 44 23 257 A1.
- a thread adjustability is also mentioned in DE 195 19 101 A1, where jagged recesses are provided at the ends of the sleeve parts of the vertebral body replacement in order to realize a radial locking relative to the vertebrae.
- the cylindrical parts of the vertebral body replacement have a plurality of recesses to improve the intergrowth with body material.
- the insertion of the vertebral body replacement from DE 195 19 101 A1 is extremely problematic, since this requires a corresponding spreading of the vertebrae.
- the known implant has too large a metallic mass with corresponding adverse postoperative consequences.
- DE 195 09 317 A1 shows an implant for insertion between vertebral bodies of the spine as a placeholder, wherein two terminal implant parts are provided which interacts with a central implant part located therebetween, which is rotatably connected to the terminal implant parts.
- the implant parts shown are formed as a tubular sleeve or as a front ring. Through intended openings bone cement can be introduced. However, these openings are only optimally suitable for introducing bone cement when they are brought to cover, which is problematic in the selected adjustment principle.
- US Pat. No. 5,236,460 shows a telescope arrangement of an implant, wherein a hardening material can be brought into the telescope space with the aid of a special tool.
- EP 0 637 439 A1 shows an implant with a wedge mechanism for height adjustment.
- there locking jaws can be swung out to dig the implant after insertion between the vertebrae.
- the US 5,290,312 is a height-adjustable vertebral implant with two U-shaped baskets, wherein the inner basket is gripped and guided by the outer basket.
- the baskets shown there are selectively fixed by screws in the vertebra and only on one side.
- a forceps or the like instrument must be used for spreading, since the implant itself has no corresponding adjustment, so that minimally invasive procedures are not possible.
- the object of the invention is to provide a further developed implant device with Betuschistsinstrumentenset that has excellent stability with the least cost of materials and which is not only a common placeholder application, but also for spreading the vertebrae and for permanent correction can be used by misalignments, so that the operational handling is very simple.
- the height-variable vertebral body implant should have optimized openings for the introduction of bone cement, wherein the coalescence is to ensure.
- the implant should also be suitable for minimally invasive procedures.
- the special adjusting device preferably has in the region of the leg connecting part a longitudinally extending slot with a toothing.
- the implant is used with retracted basket, whereby by inserting the instrument part the desired spreading, but also retraction can take place. After receiving the end position, this position is fixed by means of at least one locking screw.
- a second slot next to the first slot in the inner basket is formed.
- the baskets have vertebral support ribs which are respectively attached to the head of the inner or the foot of the outer basket. These bars are designed so that they can also be separated from the doctor or parts of it can be separated.
- the milling / eroding technique is preferably applied from a blank, so that the stability of the implant increases.
- U-shaped is also meant a polygonal shape, a semicircular or circular cylindrical shape or the like, i. is essential to be in the baskets according to the invention the possibility of telescoping meshing and the mutual support of the side walls, being ensured that adjusts a continuous lateral opening.
- the subject of the invention is thus based on a first, inner basket, which is encompassed and guided by a second, outer U-shaped basket.
- the legs of the inner and outer basket are aligned so that there is a continuous lateral opening.
- This continuous lateral opening shows at the Application to the surgeon and allows both the insertion of the tool for the stated height adjustment resp. for locking as well as the optimal insertion of bone cement.
- the legs of the inner and outer basket each have an inwardly directed curvature portion at their leg ends. In this way, despite the mentioned continuous lateral opening with acting pressure and / or rotational forces, the desired predetermined position assignment obtained without further stabilizing agents are necessary.
- a preferably embossed locking toothing is present at least in the region of the curved portions of the opposing surfaces of the baskets in order to prevent slippage or unwanted twisting of the baskets against each other.
- the height variability of the vertebral implant is realized as set forth in that the inner basket preferably in the region of the leg connecting part has a longitudinally extending first slot with a toothing to here in cooperation with the instrument a relative movement and corresponding adjustment between the baskets to reach.
- Another, second slot is preferably provided adjacent to the first slot and serves to establish or intermediate fix the adjustment position by means of locking screw.
- the locking protrusions and vertebral support surfaces or webs which are respectively provided on one of the end sides of the first and second basket, are expediently arranged alternately in order to ensure the desired flatness of the implant.
- the baskets can be made stackable via a connecting part. In this case, it is possible to provide baskets that can be extended on both sides starting from a special center section.
- the base and / or top surfaces of the baskets may have a different angle from the parallels, the anatomical conditions adapted angular position or shape.
- Ausgestaltend there is the possibility to perform the baskets in a curved shape, which are then adjustable along a circular segment guideway.
- a locking of the implant by the spread with respect to the respectively adjacent vertebral bodies is sufficient, but the possibility is provided of structuring the implant in addition, e.g. anchored by screws, so that all forces that occur in natural movements of the human body, can be safely derived.
- the Betchanistsinstrumentenset for the presented height-variable vertebral implant thus includes the instrument part with elongated guide rod and a threaded end.
- the instrument part with external teeth is formed to be hollow cylindrical for receiving the guide rod and has at the opposite end of the toothing a handle with a force acting on the guide rod thumbscrew.
- a grasping forceps is provided, which has clamping jaws which engage in corresponding recesses provided on the implant baskets.
- an endoscopically assisted implant insertion is possible in a minimally invasive surgical technique.
- the patient is prone, with surgical access via the respective spread ribs.
- the implant is prepared as follows. First, at least one locking screw is introduced into the at least one threaded hole provided in the outer basket. Here, this hole is selected, which lies in the region of another, second slot formed in the inner basket. However, this locking screw initially remains loose, so that the desired displaceability of the baskets is obtained. Now, the guide rod is inserted into the threaded hole of the outer basket, in which, which is located in a position below the first slot area. Subsequently, the instrument part is pushed with external toothing on the guide rod and thereafter implemented by rotation of the handle and tooth engagement, the rotational in a translational movement.
- the implant With retracted basket and using the grasping or holding forceps can then be used the implant.
- a corresponding representation on the grasping forceps indicates the extension direction of the basket and thus also the cranial implantation side.
- the implant can thus be introduced in the sense described above in the Corporectomid bin and aligned there accordingly with respect to the body axis.
- the implant is fixed and it is done securing the respective height position on the knurled screw on the instrument, and then tighten the at least one locking screw with the help of a screwdriver.
- the screws used or to be used are of different colors, preferably red, yellow and green, in order to specify an actuating sequence via this resulting traffic light function and to rule out any confusion. It is within the meaning of the invention to arrange not only one, but a plurality of locking screws. It is also useful to provide a mark on the guide rod, which allows the surgeon to recognize the exact position of the instrument with teeth to preclude unwanted shearing or damaging the slot-toothing section.
- the handle of the instrument part in continuation of the hollow cylindrical training be formed continuously and the guide rod a notch or the like are introduced, which emerges with the desired position of the handle end and thus visible or felt.
- the inner first basket 1 provided in its legs recesses or openings 2.
- the first inner basket 1 On the front side of the first inner basket 1 are vertebral support surfaces 3 or webs 31 and alternately to these support surfaces 3 or 31 crests extending in the longitudinal direction serrated Arret michsvorsprünge 4 provided.
- the locking projections may have a joint 16 for easier penetration into the respective opposite surface of the vortex.
- a recess (not shown) may be provided which is verklink- or verkrallbar with a tongue (not shown) of the outer basket 8 by bending.
- the surface and the shape of the implant has been optimized so that on the one hand a small amount of material is given, but on the other hand, the mechanical stability meets the particular postoperative requirements.
- Increasing the stability effect for example, the detectable stop edge 9, but also the defined radii, which are obtained by preferred machining by means of milling or erosion.
- a longitudinally extending slot 12 is formed with a toothing 13 in the various embodiments.
- a second slot 14 is adjacent to the first slot 12 extending substantially parallel arranged and used to determine the selected setting or adjustment by means of a locking screw, which is located in a threaded bore of the second outer basket 8.
- a toothing can be provided which effectively prevents undesired shifting or twisting of the baskets against one another.
- the vertebral support surfaces 3 are tongue-like formed substantially opposite one another, wherein the intermediate spaces have the mentioned locking projections 4.
- connecting webs 31 of relatively small width are present instead of the tongues, whereby e.g. of a total of three webs is assumed and one of the webs connects the two legs 10 opening side.
- the webs 31 on the one hand increase the stability of the baskets against unwanted spreading and on the other hand ensure that the surface pressure is reduced or minimized towards the vertebral body.
- the instrument part shown in Fig. 7 has an outer toothing 32 which is complementary to the toothing 13 in the first slot 12 formed. Furthermore, the instrument part is designed in the manner of a hollow cylinder 33 and has at its outer toothing 32 opposite end a handle 34.
- a bore 35 is provided with thread, which serves to receive a thumbscrew 36.
- An intended guide rod 37 shown in FIG. 8 has a threaded end 38 and a knurled handling section 39.
- the hollow cylinder 33 of the Instrument part with external teeth 32 and the outer diameter of the guide rod 37 are coordinated so that the instrument part can be moved via the guide rod quasi centered to the toothing 13 in the first slot 12.
- Fig. 9 shows in various views the lower portion of a grasping forceps 40 with jaws 41.
- the arrow indicates the extension direction of the basket and thus also the cranial implantation side.
- the upper part of the picture according to FIG. 10 allows the second slot 14 to be seen with the locking screw 42 inserted there and the lower section of a screwdriver 43.
- the locking screw 42 is loosely screwed.
- the guide rod 37 is screwed into the threaded bore 44, which is located in the outer basket below the oblong hole area 12. Subsequently, as can be seen in the lower part of the image, the instrument part pushed with external teeth on the guide rod and spent in a position that the external teeth engages the toothing 13 of the first elongated hole 12.
- the inner basket can now be moved translationally relative to the outer basket by turning the instrument part with external toothing.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Transplantation (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Public Health (AREA)
- Physical Education & Sports Medicine (AREA)
- Neurology (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
- Transplanting Machines (AREA)
Claims (17)
- Dispositif d'implant composé d'un jeu d'instruments pour le manipuler comprenant au moins une pièce d'instrument et un implant de corps vertébral réglable en hauteur avec un premier panier essentiellement en forme de U ou de C et des surfaces d'appui vertébral formées sur le panier, où le premier panier est un panier intérieur (1), entouré d'un deuxième panier extérieur en forme de U ou de C (8) et télescopiquement guidé, les côtés (10) des paniers intérieur et extérieur (1 ; 8) étant en outre orientés de manière à former une ouverture latérale traversante, et où les paniers intérieur et extérieur (1 ; 8) sont fixables l'un contre l'autre dans une position finale définie, une des faces frontales des paniers (1 ; 8) possédant en outre des surfaces d'appui vertébral (3) et/ou des traverses (31) ainsi que des saillies de blocage (4) en crêtes à extension longitudinale, et où les côtés (10) des paniers intérieur et extérieur (1 ; 8) présentent à chacune de leurs extrémités un segment courbe (5) augmentant la stabilité et dirigé vers l'intérieur, le panier intérieur (1) comportant dans la zone (11) de la pièce de jonction des côtés (10) un trou oblong (12) à extension longitudinale avec une denture unilatérale (13),
caractérisé en ce que, en coopération avec une pièce d'instrument présentant une denture complémentaire, un déplacement relatif et un ajustement se produisent entre les paniers (1 ; 8), une tige de guidage (7) étant prévue avec une extrémité filetée (38), et en ce que la pièce d'instrument à denture extérieure (32) est de forme cylindrique creuse pour le logement de la tige de guidage (7), et en ce qu'à l'extrémité opposée à la denture (32), celle-ci comporte une poignée (34) avec une vis moletée (36) agissant sur la tige de guidage (7). - Dispositif selon la revendication 1,
caractérisé en ce que, au moins dans la zone des segments courbes (5), les surfaces opposées des paniers intérieur et extérieur (1 ; 8) présentent une denture d'enclenchement, et en ce qu'un alésage fileté est présent dans le panier extérieur, dans une position située sous la zone du trou oblong. - Dispositif selon l'une des revendications précédentes, caractérisé en ce que les saillies de blocage (4) en crêtes présentent une entaille rectifiée (16) pour faciliter leur pénétration dans les surfaces de corps vertébral.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les surfaces d'appui vertébral (3) et/ou les traverses (31) et les saillies de blocage (4) respectivement prévues sur une des faces frontales des premier et deuxième paniers (1 ; 8) sont disposées en alternance.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les paniers se composent d'une pièce métallique érodée-fraisée, préférentiellement en titane.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les premier et deuxième paniers (1 ; 8) présentent une section transversale polygonale, préférentiellement rectangulaire, ou circulaire ou demi-circulaire.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que le premier panier extérieur au moins présente des évidements ou des percements (2).
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que plusieurs traverses (31) à extension parallèle formant des surfaces d'appui sont également prévues avec des largeurs différentes.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les traverses sont détachables au moins partiellement et présentent des points de rupture prédéterminés à cet effet.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les paniers sont empilables au moyen d'une pièce de jonction.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les surfaces de fond et/ou de sommet des paniers présentent une position angulaire s'écartant de la parallèle, ajustée aux particularités anatomiques.
- Dispositif selon l'une des revendications précédentes, caractérisé en ce que les paniers présentent une forme courbe et son déplaçables le long d'une glissière en arc de cercle.
- Dispositif selon l'une des revendications précédentes, caractérisé par un ancrage complémentaire sur ou dans les surfaces de corps vertébral respectives.
- Dispositif selon l'une des revendications 1 à 13, caractérisé en ce que le jeu d'instruments de manipulation comprend une pince à séquestre pour la saisie et l'orientation ou l'alignement de l'implant.
- Dispositif selon la revendication 14, caractérisé en ce que des aides à la navigation et/ou des moyens pour faciliter le positionnement d'un tournevis à maintien de vis et/ou de la tige de guidage sont disposés sur la pince à séquestre.
- Dispositif selon la revendication 14 ou 15, caractérisé en ce que pour le réglage de hauteur, la tige de guidage est d'abord introduite dans l'alésage fileté du panier extérieur, la pièce d'instrument à denture extérieure est ensuite poussée sur la tige d'instrument, et en ce que le mouvement rotatif est enfin converti en mouvement translatif par rotation de poignée et engagement de denture.
- Dispositif selon la revendication 16, caractérisé en ce qu'une position de hauteur donnée de l'implant est provisoirement fixée au moyen de la vis moletée sur la pièce d'instrument, pour ensuite fixer définitivement la position en hauteur avec une vis de blocage au moins, un autre alésage étant prévu dans le panier extérieur et un autre trou oblong, voisin du premier trou oblong, dans le panier intérieur, à cet effet.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE20005958U | 2000-03-31 | ||
DE20005958 | 2000-03-31 | ||
PCT/EP2001/003611 WO2001072246A1 (fr) | 2000-03-31 | 2001-03-29 | Implant de corps vertebral de hauteur variable |
Publications (2)
Publication Number | Publication Date |
---|---|
EP1267755A1 EP1267755A1 (fr) | 2003-01-02 |
EP1267755B1 true EP1267755B1 (fr) | 2006-05-24 |
Family
ID=7939623
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP01919410A Expired - Lifetime EP1267755B1 (fr) | 2000-03-31 | 2001-03-29 | Implant de corps vertebral de hauteur variable et kit d'instruments pour le manipuler |
Country Status (10)
Country | Link |
---|---|
US (1) | US7029498B2 (fr) |
EP (1) | EP1267755B1 (fr) |
JP (1) | JP2003527927A (fr) |
AT (1) | ATE326924T1 (fr) |
AU (2) | AU2001246520B2 (fr) |
DE (1) | DE50109876D1 (fr) |
DK (1) | DK1267755T3 (fr) |
ES (1) | ES2262637T3 (fr) |
PT (1) | PT1267755E (fr) |
WO (1) | WO2001072246A1 (fr) |
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DE102008010607A1 (de) | 2008-02-22 | 2009-08-27 | Heinrich Dr. Böhm | Implantatvorrichtung für die Wirbelsäule |
DE102010047901A1 (de) * | 2010-10-11 | 2012-04-12 | Heinrich Böhm | Implantat für die Wirbelsäule und Betätigungsinstrument |
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DE69937759T2 (de) * | 1998-10-30 | 2008-11-27 | Warsaw Orthopedic, Inc., Warsaw | Selbsträumendes, rotierbares, einsteckbares Zwischenwirbelimplantat |
DE10065232C2 (de) * | 2000-12-27 | 2002-11-14 | Ulrich Gmbh & Co Kg | Implantat zum Einsetzen zwischen Wirbelkörper sowie Operationsinstrument zur Handhabung des Implantats |
US20020156474A1 (en) * | 2001-04-20 | 2002-10-24 | Michael Wack | Polyaxial locking plate |
DE10210214B4 (de) * | 2002-03-02 | 2005-01-05 | Bernd Schäfer | Distrahierbares Wirbelsäulenimplantat und Werkzeug zum Distrahieren |
US7018415B1 (en) | 2002-09-23 | 2006-03-28 | Sdgi Holdings, Inc. | Expandable spinal fusion device and methods of promoting spinal fusion |
US7320708B1 (en) | 2002-11-13 | 2008-01-22 | Sdgi Holdings, Inc. | Cervical interbody device |
MXPA05008653A (es) | 2003-02-14 | 2006-04-27 | Depuy Spine Inc | Dispositivo de fusion intervertebral formado in situ. |
WO2004100837A1 (fr) * | 2003-05-14 | 2004-11-25 | Kilian Kraus | Implant reglable en hauteur destine a etre insere entre des vertebres et outil de manipulation |
DE20320974U1 (de) | 2003-12-11 | 2005-08-25 | Deltacor Gmbh | Längenverstellbares Wirbelsäulen-Implantat |
US7678148B2 (en) | 2004-07-23 | 2010-03-16 | Warsaw Orthopedic, Inc. | Expandable spinal implant having interlocking geometry for structural support |
EP1814474B1 (fr) | 2004-11-24 | 2011-09-14 | Samy Abdou | Dispositifs de placement d'un dispositif orthopedique intervertebral |
JP4944111B2 (ja) | 2005-08-16 | 2012-05-30 | ベンベニュー メディカル, インコーポレイテッド | 脊柱組織伸延装置 |
US8366773B2 (en) | 2005-08-16 | 2013-02-05 | Benvenue Medical, Inc. | Apparatus and method for treating bone |
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- 2001-03-29 DE DE50109876T patent/DE50109876D1/de not_active Expired - Lifetime
- 2001-03-29 WO PCT/EP2001/003611 patent/WO2001072246A1/fr active IP Right Grant
- 2001-03-29 AT AT01919410T patent/ATE326924T1/de active
- 2001-03-29 US US10/240,268 patent/US7029498B2/en not_active Expired - Fee Related
- 2001-03-29 DK DK01919410T patent/DK1267755T3/da active
- 2001-03-29 AU AU2001246520A patent/AU2001246520B2/en not_active Ceased
- 2001-03-29 PT PT01919410T patent/PT1267755E/pt unknown
- 2001-03-29 ES ES01919410T patent/ES2262637T3/es not_active Expired - Lifetime
- 2001-03-29 AU AU4652001A patent/AU4652001A/xx active Pending
- 2001-03-29 JP JP2001570209A patent/JP2003527927A/ja active Pending
- 2001-03-29 EP EP01919410A patent/EP1267755B1/fr not_active Expired - Lifetime
Cited By (5)
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DE102008010607A1 (de) | 2008-02-22 | 2009-08-27 | Heinrich Dr. Böhm | Implantatvorrichtung für die Wirbelsäule |
DE102010047901A1 (de) * | 2010-10-11 | 2012-04-12 | Heinrich Böhm | Implantat für die Wirbelsäule und Betätigungsinstrument |
WO2012048920A1 (fr) | 2010-10-11 | 2012-04-19 | Boehm Heinrich | Implant pour la colonne vertébrale et instrument d'actionnement |
US9308098B2 (en) | 2010-10-11 | 2016-04-12 | Heinrich Boehm | Implant for the spinal column and actuating instrument |
DE102010047901B4 (de) | 2010-10-11 | 2019-01-10 | Heinrich Böhm | Implantat für die Wirbelsäule und Betätigungsinstrument |
Also Published As
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ES2262637T3 (es) | 2006-12-01 |
US20030163199A1 (en) | 2003-08-28 |
EP1267755A1 (fr) | 2003-01-02 |
AU2001246520B2 (en) | 2005-08-25 |
DE50109876D1 (de) | 2006-06-29 |
JP2003527927A (ja) | 2003-09-24 |
WO2001072246A1 (fr) | 2001-10-04 |
AU4652001A (en) | 2001-10-08 |
ATE326924T1 (de) | 2006-06-15 |
DK1267755T3 (da) | 2006-09-25 |
PT1267755E (pt) | 2006-09-29 |
US7029498B2 (en) | 2006-04-18 |
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